Intestinal disease easy to treat among young, but kills 90 percent of elderly

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LONDON — The intestinal disease Fidel Castro is reportedly suffering from is usually easy to treat — but if complications develop in an elderly patient like the Cuban leader, it can quickly become a death sentence.

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The Spanish newspaper El Pais reported Tuesday that the 80-year-old Castro is suffering from diverticulitis, an inflammation of the colon that can lead to serious infection if contents from the intestine leak into the abdomen.

In the elderly, the prognosis for this kind of infection is generally very poor — with the mortality rate as high as 90 percent. “Castro would definitely qualify as critically ill,” said Dr. Roshini Rajapaksa, a gastroenterologist at New York University School of Medicine, referring to the report.

In a younger patient, even the severe complications Castro has reportedly suffered are not necessarily fatal. But Castro’s advanced age is a major factor.

“When you’re in your 80s, any complication can be fatal,” said Dr. Joel Weinstock, director of the gastroenterology department at Tufts Medical School.

Still, it is possible that Castro could recover.

“If they get the infections under control, he should get stronger in the next few weeks,” Weinstock said. “But given everything he’s supposedly been through, it would be difficult. He’s had a tough run.”

About 65 percent of people develop weak spots, or bulges called diverticula, on their colons by age 85. In about 10 percent of cases, these pouches become inflamed, causing pain and other problems, a condition called diverticulitis. The illness can become life-threatening if other complications, such as infection, occur, requiring removal of part or all of the large intestine.

Castro's entire large intestine reportedly removed
Patients with mild diverticulitis are usually treated with antibiotics, as well as being put on a liquid diet. El Pais reported that Castro had his entire large intestine removed, suggesting the infection was extremely severe.

Doctors then reportedly implanted a bile duct device, presumably to help drain the infected area, as Castro may have been too ill to have his gall bladder removed.

Additional problems — such as a clot caused by remaining immobile in bed, a heart attack due to increased stress or kidney failure — are still possible, experts said. In his weakened condition, Castro is also vulnerable to additional infections.

The El Pais report was not made public in Cuba, where the government controls the media and Cubans have become accustomed to very limited details about their ailing leader’s health.

A Cuban diplomat called the report a “lie,” and the government has not otherwise reacted.

'Very grave prognosis'
In its report, El Pais cited two unidentified sources from Gregorio Maranon Hospital in Madrid, which employs surgeon Jose Luis Garcia Sabrido, who flew to Cuba in December to treat Castro. It said a grave infection in the large intestine, at least three failed operations and various complications have left Castro with a “very grave prognosis.”

El Pais said that in December, when Garcia Sabrido visited, Castro had an abdominal wound that was leaking more than half a pint of fluids a day, causing “a severe loss of nutrients.” The Cuban leader was being fed intravenously, the report said.

Garcia Sabrido, the Madrid hospital’s chief surgeon, could not immediately be reached for comment Tuesday. A secretary who answered the phone at his office said the doctor did not plan to comment on the report.